Does attachment parenting lead to maternal depression?

At a dinner party several months ago, one of the guests, a psychiatric social worker, asked me what I do. I explained that I blog about issues of pseudoscience in parenting. She became very excited and asked me if I had ever heard of attachment parenting. She has been seeing an ever increasing number of young mothers with depression and related issues. In her experience, the increase in young mothers with depression is related to the rise of attachment parenting, which appears to dramatically increase levels of stress, feelings of failure and social isolation.

I was reminded of her observations when I came across the paper Insight into the Parenthood Paradox: Mental Health Outcomes of Intensive Mothering by Rizzo et al:

This study was conducted to provide quantitative data on the relationship between intensive parenting and maternal mental health outcomes including stress, depression, and life satisfaction. The first hypothesis was that endorsing intensive parenting attitudes would result in greater levels of stress and depression and lower levels of life satisfaction. Additionally, as Essentialism focuses on the primacy of the mother to the exclusion of other potential helpers in the family, we expected this scale to be related to lower levels of perceived family social support. The second hypothesis was that the endorsement of intensive parenting attitudes would predict maternal mental health outcomes above and beyond family social support, an already well-known predictor of well-being.

How did they measure commitment to attachment parenting?

Recently a quantitative measure of intensive parenting attitudes has been developed. This operationalization identified five factors associated with intensive parenting: Essentialism, Fulfillment, Stimulation, Challenging, and Child-Centered. Essentialism refers to the belief that mothers are the most essential parent; Fulfillment is the belief that parents should feel completely fulfilled by their children; Stimulation involves parents providing consistent intellectual stimulation for their child; Child-Centered refers to the parents’ lives totally revolving around their children; and Challenging refers to the belief that parenting is difficult and exhausting.

They measured depression, stress, life satisfaction and family support using standard diagnostic questionnaires.

What did they find?

The belief that mothers are the most capable parent (Essentialism) was associated with higher levels of stress and lower levels of life satisfaction. In prior research, mothers have expressed difficulty selecting an alternate caregiver because they felt that no one else, including the child’s father, could provide the same degree of love, commitment, and skill. If women believe they are the most capable caregiver, they may limit help from others, a practice known as maternal gatekeeping. This may account for the lower levels of social support reported by women who endorsed essentialist attitudes...

In addition:

The belief that parenting is difficult (Challenging) was related to higher levels of depression and stress, as well as lower levels of life satisfaction. If women believe that parenting is very challenging, they may experience higher levels of stress attempting to cope with the daily demands placed on them as parents. In addition, if women believe parenting is challenging, their feelings of competence as a caregiver may be diminished resulting in decreased well-being. On the other hand, already experiencing higher levels of stress and depression may lead women to view parenting as more challenging. Either way, believing that parenting is challenging, feeling stressed, and being depressed may relate to women’s decreased satisfaction with their lives.

Finally:

Believing that parents’ lives should revolve around their children (Child-Centered) was related to lower levels of satisfaction with life. According to Tummala-Narra, when women feel they must subsume their needs to the needs of their child, they lose a sense of personal freedom, which may result in women experiencing negative mental health outcomes (e.g., lower levels of life satisfaction). In contrast, child-centered beliefs were not related to stress and depression. It is possible that if a woman’s life is child- centered, meeting the demands of her children may not seem too stressful because she has already tailored her life to meet those needs. Thus, a child-centered mother may not experience as much stress related to difficulty coping with life’s demands.

The authors conclude:

The results of this study suggest that the negative maternal mental health outcomes associated with parenting may be accounted for by women’s endorsement of inten- sive parenting attitudes. So, if intensive mothering is related to so many negative mental health outcomes, why do women do it? They may think that it makes them better mothers, so they are willing to sacrifice their own mental health to enhance their children’s cognitive and socio-emotional outcomes. However, research is needed on child outcomes because, currently, there is not any data to support this assumption. In fact, young children of over-involved or over-protective parents often experi- ence internalizing disorders. In addition, research clearly indicates that the children of women with poor mental health (e.g., depression) are at higher risk for negative outcomes. Given that this study found that aspects of intensive parenting are associated with negative maternal mental health, then intensive parenting may have the opposite effect on children from what parents intend.

This study comes with lots of caveats. It is small, preliminary and it hasn't been reproduced. The issues that it raises, though, are serious and worthy of further study.

There has never been any scientific evidence to show that attachment parenting is better for children, and now there is evidence that it is worse for mothers. It may allow them to flaunt a sense of superiority, but apparently that isn't to stave off feelings of depression, stress and decreased life satisfaction.